Cerebral Palsy in Extremely Preterm Infants
Cerebral Palsy in Extremely Preterm Infants
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DOI：
10.1542/peds.2017-1433
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发表时间：
2018-01-01
期刊：
影响因子：
8
通讯作者：
Stromberg, Bo
中科院分区：
文献类型：
--
作者：
Hafstrom, Maria;Kallen, Karin;Stromberg, Bo
背景和目的：早产儿患脑瘫（CP）的风险很高，并且常常伴有其他神经发育合并症。本研究描述了基于人群的极早产儿前瞻性队列中 CP 终生患病率，包括 CP 和其他合并症（即发育迟缓和/或认知障碍、神经行为发病率、癫痫、视力和听力障碍）的类型和严重程度，以及残疾的总体严重程度。在这项研究中，我们还评估了评估时的年龄、残疾的总体严重程度和可用信息来源是否会影响结果。方法：2004 年至 2007 年期间妊娠 27 周之前出生的所有瑞典儿童均纳入其中（瑞典极早产儿研究）。综合使用了新生儿信息、2.5 岁和 6.5 岁时临床检查和神经心理学评估信息、原始医学图表审查和扩展图表审查。 结果：在 467 名 (94.5%) 符合条件的 1 岁存活儿童中确定了结果。 49 名 (10.5%) 儿童终生诊断为 CP，其中 37 名 (76%) 可以门诊。 14 人 (29%) 在 2.5 岁后诊断出 CP，37 人 (76%) 至少有 1 种其他合并症，27 人 (55%) 患有严重残疾。与没有 CP 的儿童相比，患有 CP 的儿童不完整评估的可能性更高。结论：患有 CP 的极早产儿童有各种合并症，并且通常存在严重的整体残疾。显示了对残疾儿童进行长期随访和从多个来源获取全面结果信息的重要性。
BACKGROUND AND OBJECTIVES: The risk of cerebral palsy (CP) is high in preterm infants and is often accompanied by additional neurodevelopmental comorbidities. The present study describes lifetime prevalence of CP in a population-based prospective cohort of children born extremely preterm, including the type and severity of CP and other comorbidities (ie, developmental delay and/or cognitive impairment, neurobehavioral morbidity, epilepsy, vision and hearing impairments), and overall severity of disability. In this study, we also evaluate whether age at assessment, overall severity of disability, and available sources of information influence outcome results.METHODS: All Swedish children born before 27 weeks' gestation from 2004 to 2007 were included (the Extremely Preterm Infants in Sweden Study). The combination of neonatal information, information from clinical examinations and neuropsychological assessments at 2.5 and 6.5 years of age, original medical chart reviews, and extended chart reviews was used.RESULTS: The outcome was identified in 467 (94.5%) of eligible children alive at 1 year of age. Forty-nine (10.5%) children had a lifetime diagnosis of CP, and 37 (76%) were ambulatory. Fourteen (29%) had CP diagnosed after 2.5 years of age, 37 (76%) had at least 1 additional comorbidity, and 27 (55%) had severe disability. The probability for an incomplete evaluation was higher in children with CP compared with children without CP.CONCLUSIONS: Children born extremely preterm with CP have various comorbidities and often overall severe disability. The importance of long-term follow-up and of obtaining comprehensive outcome information from several sources in children with disabilities is shown.